Saad Maria Auxiliadora Nogueira, Rosa Maria Luiza Garcia, Lima Giovanna Balarini, Antunes da Cruz Rubens
Faculdade de Medicina da Universidade Federal Fluminense, Niterói, Brasil.
Instituto de Saúde Coletiva, Universidade Federal Fluminense, Niterói, Brasil.
Cad Saude Publica. 2017 Aug 21;33(8):e00060916. doi: 10.1590/0102-311X00060916.
This study focused on the correlation between neck circumference and other anthropometric measurements and cardiovascular risk factors and insulin resistance in the elderly in Niterói, Rio de Janeiro State, Brazil. This was a cross-sectional study in 411 patients seen in primary care. Anthropometric measurements including neck circumference, body mass index (BMI), waist circumference (WC), and waist-hip ratio (WHR) were recorded. Bioelectrical impedance analysis (BIA) estimated the percentage of total body fat (%TBF). Insulin resistance was estimated by HOMA-IR (homeostasis model assessment IR index). The data were analyzed by the Mann-Whitney test and the correlation between numerical variables by Spearman's test. Receiver operating characteristic (ROC) was used to assess the anthropometric measurements' predictive capacity to diagnosis insulin resistance. Neck circumference was positively correlated with WC, BMI, WHR, %TBF, and HOMA-IR in both sexes. In women, neck circumference showed higher AUC (area under the curve) for insulin resistance. In men, WC showed higher AUC, followed by BMI and neck circumference. The current study in Southeast Brazil suggests that neck circumference can predict insulin resistance, an important marker of cardiovascular risk in the elderly population treated in primary care.
本研究聚焦于巴西里约热内卢州尼泰罗伊市老年人的颈围与其他人体测量指标、心血管危险因素及胰岛素抵抗之间的相关性。这是一项针对411名在初级保健机构就诊患者的横断面研究。记录了包括颈围、体重指数（BMI）、腰围（WC）和腰臀比（WHR）在内的人体测量指标。生物电阻抗分析（BIA）估算了全身脂肪百分比（%TBF）。通过稳态模型评估胰岛素抵抗指数（HOMA-IR）估算胰岛素抵抗。数据采用曼-惠特尼检验进行分析，数值变量之间的相关性采用斯皮尔曼检验。采用受试者工作特征（ROC）曲线评估人体测量指标对胰岛素抵抗的诊断预测能力。颈围在两性中均与腰围、BMI、腰臀比、全身脂肪百分比及HOMA-IR呈正相关。在女性中，颈围对胰岛素抵抗的曲线下面积（AUC）更高。在男性中，腰围的AUC更高，其次是BMI和颈围。巴西东南部的这项当前研究表明，颈围可预测胰岛素抵抗，而胰岛素抵抗是初级保健中治疗的老年人群心血管风险的一个重要标志物。
